Accutane is our gold standard of treatment for acne. Typically patients start with topical treatments, then progress to oral treatments, then they can progress to laser treatments or photo dynamic therapy. I may also consider hormonal therapy for treatment of acne. If all else fails I will put them on accutane. 

What are some concerns for Accutane?

Accutane has gotten a lot of negative press because of the effect that it has on unborn fetuses. It is true that accutane should not be taken during pregnancy because of the severe deformities that will occur. The child will most likely be incompatible with life. This is a valid concern. 

Another concern is the link between accutane and depression. There was a politician’s son that committed suicide while taking accutane. It is unclear if the depression was a result of the acne, a pre-existing condition or the drug itself. Needless to say this brought a lot of negative media attention to the drug. This lead to iPledge. A service that closely monitors the users that takes accutane and the way it is prescribed. 

The third and final concern is inflammatory bowl disease. 

I personally took accutane after failing topical medications, oral medications, herbal remedies and acupuncture. When I took acccutane it cured me. I believe it is a product that should be offered to patients. 

How is Accutane taken, what does Accutane do?

Accutane is derived from vitamin A or isotretinoin. It is ingested into the body and delivered through the blood stream into the hair follicles. The significant thing about accutane is that it significantly shrinks the oil glands permanently. 

A typical coarse of accutane will last six months. Women have to take pregnancy test while both men and woman have to consent to blood tests that are done monthly. 

What are some side-effects of Accutane?

Within two weeks patients should notice a significant reduction of blemishes. I monitor side effects like headaches, dizziness, blurry vision and upset stomach. I always ask about mood swings and or depression. My goal in dosing acctane is to increase the dose monthly until the patient no longer breaks out. By the time the course has expired they should be free of acne. If the patient has not cleared by six months, I will extend their course. I will stop them at nine months and take them off the medication even if they have not completely cleared. This rarely happens. 

70-80% of patients never get acne again20% of patients may have to take a second or third course.Rarely a very small % of patients don’t respond to accutane.